Just an occasional post when I come upon a few interesting reports that are worth a download or browse. This week we have a few.
First we have:
May 18, 2009 4:00 AM PST
Walk though a typical Kaiser Permanente doctor's office or hospital, and you won't find a paper chart lying around. Kaiser, with 450 hospitals and offices around the country, is almost entirely paperless.
But as the rest of the health care industry rushes to follow in Kaiser's digital footsteps, Kaiser's paperless success story--a 10-year, $4 billion effort--might actually serve as a cautionary tale.
By no means has the Kaiser e-health project failed. In fact, besides some hiccups, it has gone well: Kaiser said it has seen more satisfied patients and a slight dip in emergency room visits and hospital stays, which cuts costs. Even the doctors grumbling the loudest beforehand don't know what they would do if they were forced back to paper.
Unfortunately, the rest of the health care system looks nothing like Kaiser.
Kaiser is a rare beast: both an insurance provider and medical provider. Investing in digital technology was projected to create efficiencies in its medical services and boost the bottom line.
Most hospitals don't operate like that. They provide a service, bill the insurance company or the government, and move on to the next patient, efficiency be damned.
Nonetheless, the United States appears to be barreling ahead with a far-reaching health care digitization effort that even proponents say leaves many questions unanswered. The Obama stimulus package provides $19 billion for hospital technology efforts, which could go a long way toward prodding penny-pinching hospitals and doctors to finally leap into the 21st century.
More here (including links to many other articles, multimedia etc):
This is a pretty comprehensive discussion of the views in the US as they plan to move forward with e-Health. Many links and well worth a browse!
Second we have:
18 May 2009
Danish research has found that using simulators to train surgeons can make them twice as quick and more precise when operating.
A study carried out by a team at Copenhagen University Hospital to assess the effect of virtual reality training on keyhole surgery showed that surgeons trained using simulators took a median time of 12 minutes to complete the operation.
Those trained using traditional methods, learning by solely working alongside doctors, took a median time of 24 minutes to carry out the same procedure.
The study, published in the current issue of the British Medical Journal, also showed that the performance level of novices trained on the simulator was comparable to that of intermediately experienced laproscopists and that they carried out better work.
The paper abstract can be accessed here:
and the full paper here:
The conclusion says it all:
“Conclusion Skills in laparoscopic surgery can be increased in a clinically relevant manner using proficiency based virtual reality simulator training. The performance level of novices was increased to that of intermediately experienced laparoscopists and operation time was halved. Simulator training should be considered before trainees carry out laparoscopic procedures.”
Third we have:
May 18, 2009
The Office of the National Coordinator for Health Information Technology has released to Congress an operating plan for implementing provisions of the HITECH Act within the American Recovery and Reinvestment Act.
“This operating plan outlines immediate actions to meet statutory requirements and to begin the huge task ahead,” according to the eight-page document. “Over the next several weeks, ONC will hold hearings and meetings to develop and vet plans and procedures.”
The plan describes 19 upcoming regulations, guidance, reports and studies regarding the enhanced HIPAA privacy and security rules, and their due dates under the law. It also lists six tasks, and due dates, for heightened enforcement of the rules.
The operating plan is found here:
Fourth we have:
May 19, 2009 (OAKLAND, Calif.) An e-mail intervention program is an effective way to significantly improve diet and physical activity by helping people move more, sit less, and make healthier food choices, according to a Kaiser Permanente Division of Research study in the American Journal of Preventive Medicine.
The study was a randomized controlled trial of the ALIVE (A Lifestyle Intervention Via E-mail) program conducted among 787 Kaiser Permanente Northern California employees at their worksites. Through the ALIVE program, developed by NutritionQuest, (www.nutritionquest.com) weekly e-mails were sent to the 351 employees randomized to the intervention group; the 436 employees in the control group received only immediate e-mail feedback at the start of the intervention indicating whether or not their reported physical activity and diet met national guidelines. The messages to the participants in the intervention group suggested small, practical, individually tailored goals, such as eating fruit for a snack three times a week, walking for 10 minutes a day at lunch time, or walking to the store instead of driving.
At the end of the 16-week trial, the participants in the intervention group were more physically active, eating more fruits and vegetables, and reducing their intake of saturated fats and trans fats, compared to the control group. The biggest changes occurred among those in the intervention group, who did not meet behavioral recommendations at the start of the trial. For example, employees who were not regularly active before receiving the intervention increased their participation in moderate intensity physical activities by almost an hour a week and decreased the amount of time they spent in sedentary activities, like watching TV and videos, by about two hours a week. These changes had a lasting effect four months after the intervention ended, the study found.
"The takeaway message here for people who want to improve their diet and physical activity, and for employers who want a healthier workforce, is that e-mail intervention programs are a very cost-effective way to get healthy," said study lead investigator Barbara Sternfeld, Ph.D., senior research scientist with the Kaiser Permanente Division of Research and the study's lead investigator. "A tailored e-mail program includes all the things that behavioral scientists have said for years about changing behavior: small goals tailored for the individual, reinforcement, and tracking but delivered in a mass, cost-effective way."
The report abstract is found here:
More information about what works!
Fifth we have:
Patients Reveal A Willingness to Trade Hands-On Medical Care for Computer Consultations
Study also finds that Internet-savvy consumers will trade some privacy in order to gain transparency, full access to medical records
BIDMC Contact: Bonnie Prescott
BOSTON -- As President Barack Obama calls for streamlining heath care by fully converting to electronic medical records and as Congress prepares to debate issues of patient privacy, one question has largely gone unasked: What do patients want?
A qualitative study led by a research team at Beth Israel Deaconess Medical Center (BIDMC) helps answer that question. Reported in the June 2009 issue of the Journal of General Internal Medicine (JGIM), the findings provide key insights into consumer preferences, suggesting that patients want full access to all of their medical records, are willing to make some privacy concessions in the interest of making their medical records completely transparent, and that, going forward, fully expect that computers will play a major role in their medical care, even substituting for face-to-face doctor visits.
“We set out to study patient attitudes toward electronic personal health records and other emerging and future electronic health information technologies,” explains the study’s lead author Jan Walker, RN, MBA, Instructor in Medicine in the Division of General Medicine and Primary Care at BIDMC and Harvard Medical School. “And we learned that, for the most part, patients are very comfortable with the idea of computers playing a central role in their care.” In fact, she adds, patients said they not only want computers to bring them customized medical information, they fully expect that in the future they will be able to rely on electronic technology for many routine medical issues.
The report is here (subscription required):
This is a valuable study of patient attitudes that needs to be widely reviewed and discussed.
Sixth we have:
Posted: May 22, 2009 - 11:00 am EDT
Investing in health information technology is doomed to fail if it's treated as a pure technology implementation program, authors of a new health IT report said during a teleconference sponsored by the Center for American Progress Action Fund.
The billions of dollars in health IT investment authorized under the American Recovery and Reinvestment Act of 2009 “presents a landmark opportunity to catalyze improvement of our nation’s healthcare system,” according to the report, A Historic Opportunity: Wedding Health Information Technology to Care Delivery Innovation and Provider Payment Reform. However, if the funds are simply used for the sake of technology adoption, health IT is not going to work, said Judy Feder, senior fellow with the Center for American Progress Action Fund.
Seventh we have:
May 18, 2009
A consulting and outsourcing firm has prepared a free white paper on how medical record data can be more effectively integrated into research studies
To view the white paper, “Medical Record Data Abstraction…Simplified,” visit carecommunications.com.
Link is in text.
Last we have:
May 20, 2009 | Molly Merrill, Associate Editor
CHICAGO – A new study identifies the top five challenges senior IT executives face when implementing wireless applications and devices in the healthcare setting.
HIMSS Analytics used two focus groups for the March study, ranging from large (1,000+-bed) urban health systems to small (100-bed) rural organizations.
According to the HIMSS Analytics Database, approximately one-third of U.S. hospitals use wireless technology.
"In theory, secure mobile access to medical records and imaging, prescriptions and even general administrative databases should allow doctors, nurses and medics to treat more patients faster, more accurately and with greater flexibility – from any location in a large hospital, during home visits or at the scene of an ambulance response," said Jennifer Horowitz, senior director of research for HIMSS Analytics. "However, often the anticipated productivity gains are hampered by a series of fairly common issues related to wireless networks. This report examines some of those key issues and identifies some approaches healthcare agencies are utilizing to address them."
The results of the study are now published in a free report available for download at www.netmotionwireless.com/resources/whitepapers
So much to read – so little time – have fun!